Article record

功能成像引导下使用弥散加权磁共振成像进行唾液腺保护性放射治疗的急性治疗不良事件和患者报告生活质量的 interim 分析

An interim analysis of acute treatment adverse events and patient reported quality of life for functional imaging guided salivary gland sparing radiation therapy using diffusion-weighted magnetic resonance imaging.

临床研究鼻科IF 3.4Q2

文献信息

PMID	42898154
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Katelyn Cahill 查看其他 13 位作者 Catriona Hargrave；Kane Miller；Alexandria Leppien；Claudia Chapple；Jasmine Meaghan；Michelle Phan；Mark Denham；Patrick O'Connor；Alan Ho；David Hogan；Joanne Castelli；Zack Y Shan；Myo Min
作者单位	Adem Crosby Centre - Radiation Oncology, Sunshine Coast University Hospital, Birtinya, QLD, Australia. 查看其他 8 条单位信息 Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia.；Radiation Oncology Princess Alexandra Hospital Raymond Terrace, Brisbane, QLD, Australia.；Faculty of Health, School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.；Department of Medical Imaging, Sunshine Coast University Hospital, Brisbane, QLD, Australia.；School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia.；Queensland Cyber Infrastructure Foundation (QCIF) Statistics, Brisbane, QLD, Australia.；Ear Nose Throat Senior Medical Department, Sunshine Coast University Hospital, Birtinya, QLD, Australia.；School of Medicine and Dentistry, Griffith University, Sunshine Coast Health Institute, Birtinya, QLD, Australia.
期刊	Physics and imaging in radiation oncology
SCI 分区	Q2
IF	3.4
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

背景与目的： 不断发展的证据表明，在头颈癌放射治疗中对腮腺进行区域保护可减少放射性口干症。本 interim 分析探讨弥散加权磁共振成像（DW-MRI）衍生的腮腺生物学风险体积（BRV）剂量与急性不良事件（包括患者报告的生活质量（QoL））之间的功能关系。
材料与方法： 24 例头颈癌患者接受 MRI 模拟，以使用 DW-MRI 衍生的表观弥散系数测量勾画腮腺 BRV。优化剂量，保护腮腺 BRV。记录临床医生报告的急性不良事件（口干症、吞咽困难、口腔疼痛），并使用华盛顿大学生活质量问卷 v4.1（经放射治疗肿瘤学组修改）评估患者报告的 QoL。不良事件使用曲线下面积量化，并计算和分析副作用峰值时间。
结果： 观察到对侧 BRV 平均剂量与口干症曲线下面积之间存在中度正相关趋势，但未达到统计学显著性（r = 0.34，p = 0.13）。对侧 BRV 区域与吞咽困难达峰天数之间存在强关系（r = 0.56，p = 0.005）。低剂量和高剂量分组分析显示口干症达峰时间有接近显著的趋势（p = 0.059）。同侧腮腺 BRV 无显著关联。
结论： 研究结果提示对侧 BRV 平均剂量与急性口干症之间可能存在功能性剂量关系。正在进行的随访将确定急性期观察到的提示性趋势是否会随着长期恢复时间而增强。

英文摘要

BACKGROUND AND PURPOSE: Evolving evidence suggests that regional sparing of the parotid gland during radiation therapy could reduce radiation-induced xerostomia in head and neck cancer. This interim analysis investigates the functional relationship between the diffusion-weighted magnetic resonance imaging (DW-MRI) derived parotid gland biological at-risk volume (BRV) dose and acute adverse events, including patient-reported quality of life (QoL).
MATERIALS AND METHODS: Twenty-four head and neck cancer patients underwent MRI-simulation to delineate parotid gland BRVs using DW-MRI derived apparent diffusion coefficient measurements. Dose was optimised, sparing the parotid gland BRV. Clinician-reported acute adverse events (xerostomia, dysphagia, oral pain) were recorded and patient-reported QoL was assessed using University of Washington QoL Questionnaire v4.1 with Radiation Therapy Oncology Group modification. Adverse events were quantified using area under the curve and time to side effect peaks were calculated and analysed.
RESULTS: A moderate positive correlation trend was observed between contralateral BRV mean dose and xerostomia area under the curve, although this did not reach statistical significance (r = 0.34, p = 0.13). There was a strong relationship between the contralateral BRV sector and days to peak dysphagia (r = 0.56, p = 0.005). Low- and high-dose grouped analysis revealed a trend toward significance for time to peak xerostomia (p = 0.059). There were no significant associations with the ipsilateral parotid gland BRVs.
CONCLUSION: Findings suggest a potential functional-dose relationship between the contralateral BRV mean dose and acute xerostomia. Ongoing follow-up will determine whether the suggestive trends observed in the acute phase strengthen with long-term recovery time.